434418107-6-12-2026-07-CC-MKAR-DUXTWU-20260611150605

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434418107
Report Date: 06/11/2026
Date Signed: 06/12/2026 08:01:10 AM

Document Has Been Signed on 06/12/2026 08:01 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	GARAY, IVAN		FACILITY NUMBER:	434418107
ADMINISTRATOR/ DIRECTOR:	IVAN GARAY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 542-9723
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	06/11/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:35 AM
MET WITH:	Ivan Garay		TIME VISIT/ INSPECTION COMPLETED:	03:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 06/11/2026, Licensing Program Analyst(LPA) Mandeep Kaur conducted an announced prelicensing inspection. LPA met with Applicant, Ivan Garay and explained the reason for the inspection. Purpose of this inspection; Applicant applied for a Large Family Child Care Home (FCCH) license. Also, present in the home was Applicant's mother/assistant(S1) and Applicant's father(A1). The Applicant and Applicant's parents are the only adults residing in the home. Fire inspection for Large Family day care home was granted on February 27, 2026. The hours of operation will be Monday through Friday 8AM to 6:00PM. Applicant does plan on obtaining liability insurance for the day care home. Applicant understands that parents will need to fill out the Affidavit Regarding Liability Insurance (LIC 282) if he does not plan on obtaining liability insurance for the day care home. Applicant has a valid pediatric CPR/1st Aid certificates which expire on January 25, 2027. Applicant's Preventive Health and Safety certificate and Mandated Reporter training certificate are on file. Applicant completed the Preventative health and Safety training on April 23, 2022 and Mandated Reporter training on March 09, 2026. LPA reminded Applicant that the Mandated Reporter training and CPR/1st Aid requires renewal every two years. Applicant's immunization records for TB, measles, pertussis, and influenza are also on file. Applicant provided proof of control of property (Copy of Lease agreement on file). Because the Applicant rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the Applicant confirms was provided to the property owner/landlord. The Applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Continue on next pages

NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GARAY, IVAN	FACILITY NUMBER: 434418107
	VISIT DATE: 06/11/2026

NARRATIVE

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LPA toured the inside and outside of the home with Applicant. Applicant resides in a single story single family home. Off limit areas in the home include the kitchen, storage room in the kitchen, Bedroom 2, a bathroom inside the bedroom 2, Closet in Bedroom 1, and closet in bedroom 3. Offlimit areas outside the home are: detached garage, a barricaded small area behind garage, locked storage (shed), barricaded area next to locked storage(shed) and left side of the home.

During today's inspection, Applicant has submitted the updated facility sketch with the emergency arrows and without any changes to the offlimit and onlimit areas of the day care home that was approved by Fire Department on February 27, 2026. Applicant does not plan to transport the children. LPA advised the applicant that children need to be supervised at all times.

The home is clean, orderly, including heating and air conditioning, for safety & comfort. The Applicant has a
valid phone in the home. There is sufficient toys, supplies, and equipment for the day care children indoors and outdoors.

LPA observed a fully charged fire extinguisher, working combo smoke & carbon monoxide detectors, no bodies of water, and fenced backyard. There is no fire place inside the home. Applicant stated that there are no pets and no weapons/ammunition in the home.

All disinfectant, cleaning supplies, and other items that could pose a risk to children were inaccessible. There were no baby walkers or bouncers observed in the on-limit areas for the children. Applicant understands that baby walkers or other similar items are not permitted for the children. LPA reminded Applicant that fire/disaster drill need to be conducted and documented every six (6) months.

Facility will provide morning snack, lunch, afternoon snack and dinner to the children in care. Healthy beverage requirements were discussed and provided to the applicant. Facility will not serve juice to the children in care.

Forms of discipline to be used by Applicant: talk to the children. Applicant understands that children's personal rights should not be violated; including no corporal punishment. isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed.
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NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GARAY, IVAN	FACILITY NUMBER: 434418107
	VISIT DATE: 06/11/2026

NARRATIVE

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LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage at:
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPAs also informed Applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and
recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased
equipment.

Applicant stated that he may not administer medication for the children in care. Applicant stated that a
child(ren) who may get sick while in care, will be isolated in the bedroom 1 if necessary due to illness or communicable disease and away from the other children. Applicant has a First Aid kit with a touchless thermometer in the home.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes,
children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

All adults have cleared criminal record clearance, child abuse index, and TB. Applicant was reminded that all
adults 18 and over living in the home, persons who provide care and supervision to children, and staff who
have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

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NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: GARAY, IVAN	FACILITY NUMBER: 434418107
	VISIT DATE: 06/11/2026

NARRATIVE

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On this date, 02/13/2026, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and
stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other
important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child
Care option to receive email communication.

No deficiency issued during today's investigation. Appeal rights provided.

As a result of this inspection, a license for a Large Family Child Care Home is granted effective June 12, 2026.

Exit interview conducted and report was reviewed with the Applicant, Ivan Garay.

NAME OF LICENSING PROGRAM MANAGER: Mireya Flores
NAME OF LICENSING PROGRAM ANALYST: Mandeep Kaur
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/11/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026

LIC809 (FAS) - (06/04)

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